Focus Of Infection Research Articles

Microbiological substantiation of the effectiveness of quercitin and its combination with ethylmethylhydroxypyridine succinate in the complex treatment of odontogenic phlegmon and maxillofacial abscesses.

The cross-sectional study included 75 patients. Purulent exudate was collected from the infection site. The number of colony-forming units was counted using the standard plate method. The microbiological examination of purulent exudate obtained from the patients revealed the general prevalence of Gram-positive cocci. On the seventh day of treatment, the total number of microorganisms in the purulent exudate of patients in group I, whose treatment included a combination of the standard protocol with quercitin, significantly decreased compared to the first day of the same group. The results of treatment of patients in group II, which included the standard protocol in combination with quercitin and 2-ethyl-6-methyl-3-hydroxypyridine succinate, demonstrate a significant decrease in the total number of bacteria in the infection focus on the fifth day of treatment compared to this indicator of the group at the beginning of the study. When quercitin was used as part of complex treatment, the total treatment period was reduced by 1.4 days. However, the combined use of quercitin and ethylmethylhydroxypyridine succinate against the background of standard treatment of patients with odontogenic infection contributed to a reduction in hospital stay by 2 days.

A Rare Agent in Wound Infection: Leclercia adecarboxylata

As a rare infectious agent, Leclercia adecarboxylata is a gram-negative bacillus belonging to the Enterobacteriaceae family. It can be isolated from human blood, sterile body fluids, sputum, urine, fecal, and wound samples. In this case report, the isolation of L. adecarboxylata as a causative agent in the wound and tissue sample cultures of a soft tissue infection that developed after arthrodesis surgery on the right foot of a 47-year-old female patient who was followed up with Charcot foot treatment due to diabetes in our hospital is presented. The patient's general condition was good, his leukocyte count was 6000/ml, leukocyte distribution was 58% neutrophil predominance, erythrocyte sedimentation rate was 105 mm/hour, and C-reactive protein level was 90 mg/L. Wound and tissue samples from the area considered to be the focus of infection were sent to our laboratory for culture examination. In the samples inoculated into routine identification media and subjected to standard incubation and identification procedures, a growth consisting of pure colonies (monomicrobial) was detected on the culture media. The isolate was identified as L. adecarboxylata by colony morphology, microscopic examinations (gram-negative bacilli), other basic identification procedures, and mass spectrometry (MALDI-TOF MS). Since it is a rare infectious agent, additional biochemical tests were performed; glucose-sucrose-lactose utilization, motility, indole production, and esculin hydrolysis tests were found to be positive, while oxidase, ornithine decarboxylase, hydrogen-sulfide production, citrate utilization, and urease tests were found to be negative. Antibiotic susceptibility tests were performed with the VITEK 2® automated system (Biomérieux, France), and the results were evaluated according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) v13.0 criteria. The isolate, which has a generally sensitive antibiotic profile, was evaluated as the infectious agent and the patient was treated with intravenous ampicillin/sulbactam for five days. The patient, whose laboratory values tended to improve (leukocyte count 4400/ml, neutrophil rate 52.9%), was discharged with peroral amoxicillin/clavulanic acid treatment.

Characteristics of tickborne infections in the underexplored areas of the Trans-Baikal Territory

Background. Infections transmitted to humans by the bites of ixodid ticks remain an urgent public health problem. In this work we explored the natural foci of tickborne infections located in the valley of the Chikoy River, which is a part of the buffer zone of the Baikal natural territory.The aim. To characterize the modern diversity and prevalence of tick-borne pathogens in the ecosystems of the valley of the Chikoy River (Trans-Baikal Territory, Russian Federation).Materials and methods. Thirteen sampling sites were located in typical biotopes throughout the Chikoy valley. In total 48 adult Ixodes persulcatus ticks, 1 female Haemaphysalis concinna tick and 38 specimens of small mammals were studied. All samples were tested for infection with seven tick-borne pathogens using multiplex real-time PCR.Results. No pathogens were detected in the H. concinna specimen. No R. sibirica and R. heilongjiangensis were detected both in ticks and in rodents. Among I. persulcatus, tick-borne encephalitis virus (TBEV), and the prevalence of Borrelia burgdorferi s. l. comprised 39.5 %, A. phagocytophilum – 16.7 %, B. miyamotoi – 8.3 % and Ehrlichia sp. – 2.1 %. Among infected ticks 6.2 % were co-infected with B. burgdorferi s. l. and A. phagocytophilum. Four rodent hosts of ticks and infections were identified: Myodes rufocanus (44.7 %), Apodemus peninsulae (39 %), Microtus oeconomus (13.2 %) and M. rutilus (2.6 %). Mean prevalence of B. burgdorferi s. l. in rodents comprised 39.5 %, B. miyamotoi – 28.9 %, Ehrlichia sp. – 21.1 % and A. phagocytophilum – 18.4 %. TBEV was detected in 5.3 % of rodents.Conclusion. At least five tick-borne pathogens circulate in the Chikoi River valley, i. e. TBEV, B. burgdorferi sensu lato, A. phagocytophilum, B. miyamotoi and Ehrlichia sp. The wide spread of I. persulcatus and abundance of competent rodent hosts of infections and ticks indicates that natural foci of tick-borne diseases are widely distributed in the Chikoi River valley.

Eubacterium bacteremia – a retrospective observational study of a seldom found anaerobic pathogen

BackgroundHuman infections due to Eubacterium are rare and knowledge of the condition is limited. This study aimed to describe clinical characteristics and outcome in patients with Eubacterium bacteremia. MethodsEpisodes of Eubacterium bacteremia were identified through the clinical microbiology laboratory in Lund, Sweden. Medical records were retrospectively reviewed. Blood isolates of Eubacterium were collected and antibiotic susceptibility testing was performed with agar dilution. ResultsSeventeen patients with Eubacterium bacteremia were identified of whom six had monomicrobial bacteremia. The incidence was 1.7 cases of Eubacterium bacteremia per million inhabitants and year. The median age was 67 years (interquartile range 63-79 years), and six patients had some form of malignancy. Most of the patients an abdominal focus of infection and the 30-day mortality was low (n = 1). ConclusionsInvasive infections with Eubacterium have a low incidence. The condition has a low mortality and an abdominal focus of infection, and malignancy, is common.

Identifying biomarkers deciphering sepsis from trauma-induced sterile inflammation and trauma-induced sepsis.

The purpose of this study was to identify a panel of biomarkers for distinguishing early stage sepsis patients from non-infected trauma patients. Accurate differentiation between trauma-induced sterile inflammation and real infective sepsis poses a complex life-threatening medical challenge because of their common symptoms albeit diverging clinical implications, namely different therapies. The timely and accurate identification of sepsis in trauma patients is therefore vital to ensure prompt and tailored medical interventions (provision of adequate antimicrobial agents and if possible eradication of infective foci) that can ultimately lead to improved therapeutic management and patient outcome. The adequate withholding of antimicrobials in trauma patients without sepsis is also important in aspects of both patient and environmental perspective. In this proof-of-concept study, we employed advanced technologies, including Matrix-Assisted Laser Desorption/Ionization (MALDI) and multiplex antibody arrays (MAA) to identify a panel of biomarkers distinguishing actual sepsis from trauma-induced sterile inflammation. By comparing patient groups (controls, infected and non-infected trauma and septic shock patients under mechanical ventilation) at different time points, we uncovered distinct protein patterns associated with early trauma-induced sterile inflammation on the one hand and sepsis on the other hand. SYT13 and IL1F10 emerged as potential early sepsis biomarkers, while reduced levels of A2M were indicative of both trauma-induced inflammation and sepsis conditions. Additionally, higher levels of TREM1 were associated at a later stage in trauma patients. Furthermore, enrichment analyses revealed differences in the inflammatory response between trauma-induced inflammation and sepsis, with proteins related to complement and coagulation cascades being elevated whereas proteins relevant to focal adhesion were diminished in sepsis. Our findings, therefore, suggest that a combination of biomarkers is needed for the development of novel diagnostic approaches deciphering trauma-induced sterile inflammation from actual infective sepsis.

Socio-Demographic and Eco-Epidemiological Parameters of Tick-Borne Infections Morbidity in Baikal Region

The aim of the work was to compare the main socio-demographic and eco-epidemiological parameters of tick-borne viral encephalitis, tick-borne borrelioses and tick-borne rickettsiosis.Materials and methods. The authors’ databases based on epidemiological investigation records were used for the study. All in all, 2974 cases (Irkutsk and the Irkutsk district) were analyzed during the periods of 1995–2022 for tick-borne viral encephalitis and tick-borne borrelioses, and 2001–2022 for tick-borne rickettsiosis.Results and discussion. The following parameters were assessed: the timing of epidemic season; the geography of prevalence; localization of tick bite on the human body; incubation time; gender and age structure of patients; social composition and exposure conditions. It was shown, that the parameters had their own features for each disease, and part of them are common to all Eurasian area of these infections. The shared characteristics include: the early epidemic season onset for tick-borne rickettsiosis; the shorter incubation time for tickborne rickettsiosis as compared to tick-borne viral encephalitis and tick-borne borrelioses; the increased frequency of tick-borne rickettsiosis vectors’ bites near the head and neck, and tick-borne borrelioses vectors – on the torso; large percentage of older persons among patients with tick-borne borrelioses and children under 14 years of age among patients with tick-borne rickettsiosis; prevalence of male population over female one as regards all surveyed pathogens. Low incidence of tick-borne diseases among professional contingent (the work associated with staying in natural foci of infection), an increased risk of tick-borne encephalitis and rickettsiosis among social group “unemployed”, and tick-borne borrelioses – among retirees, can be attributed to regional specificity.

Insecticide susceptibility in a planthopper pest increases following inoculation with cultured Arsenophonus.

Facultative vertically transmitted symbionts are a common feature of insects that determine many aspects of their hosts' phenotype. Our capacity to understand and exploit these symbioses is commonly compromised by the microbes unculturability and consequent lack of genetic tools, an impediment of particular significance for symbioses of pest and vector species. Previous work had established that insecticide susceptibility of the economically important pest of rice, the brown planthopper Nilaparvata lugens, was higher in field-collected lineages that carry Ca. Arsenophonus nilaparvatae. We established Ca. A. nilaparvatae into cell-free culture and used this to establish the complete closed genome of the symbiont. We transformed the strain to express GFP and reintroduced it to N. lugens to track infection in vivo. The symbiont established vertical transmission, generating a discrete infection focus towards the posterior pole of each N. lugens oocyte. This infection focus was retained in early embryogenesis before transition to a diffuse somatic infection in late N. lugens embryos and nymphs. We additionally generated somatic infection in novel host species, but these did not establish vertical transmission. Transinfected planthopper lines acquired the insecticide sensitivity trait, with associated downregulation of the P450 xenobiotic detoxification system of the host. Our results causally establish the role of the symbiont in increasing host insecticide sensitivity with implications for insecticide use and stewardship. Furthermore, the culturability and transformation of this intracellular symbiont, combined with its ease of reintroduction to planthopper hosts, enables novel approaches both for research into symbiosis and into control of insect pest species.

The Epidemic Situation of Tularemia in Karelia at the Present Time

Tularemia is a natural focal infection, characterized by the ability to maintain epizootic and epidemic potential for decades and periodically become more active. Since 2016, an increase in the incidence of tularemia has been observed in the Republic of Karelia.Aims. To evaluate the epidemiological situation with tularemia in the Republic of Karelia to determine the directions of preventive work in modern conditions.Conclusions. Analysis of the epizootic and epidemiological situation regarding tularemia in the Republic of Karelia demonstrates the possibility of intensifying the epizootic process after decades of relative prosperity. The increase in the incidence of the population was not only the result of the activation of natural foci of infection, but also of improved diagnosis of the disease and change in tactics for using vaccines in areas enzootic for tularemia.

Salivary biochemical parameters in people living with HIV on ART and dental caries: a cross-sectional study in Monastir, Tunisia

BackgroundStudies regarding salivary biochemical parameters and dental caries in adult people living with HIV/AIDS (PLWHA) are scanty. Aim: To investigate salivary biochemical parameters and dental caries in adult PLWHA who are on antiretroviral therapy (ART) and compare the findings with people negative for HIV infection.MethodsThe study included 50 HIV positive individuals as a test group (TG) and 50 HIV negative individuals as a control group (CG). Dental examination was performed according to WHO guidelines to assess DMFT. Digital panoramic radiographs were taken to detect additional infectious foci. Non-stimulated saliva was collected between 9 and 12 a. m for 5 min to evaluate 18 biochemical parameters and salivary flow rate (SFR). Parametric and non parametric tests were used according to data distribution. The level of significance was set at p < 0.05%.ResultsPatients’ mean ages and M/F sex ratios for TG and CG were 38.80 ± 9.69 y/o. vs. 37.98 ± 13.47 y/o. and 3.54 vs. 2.33, respectively. Higher means of decayed teeth were recorded in TG, 4.47 ± 3.00 vs. 3.88 ± 2.81 in CG with no significant difference (p = 0.41). Means of filled teeth were significantly lower in TG 2.38 ± 2.16 vs. 4.16 ± 3.35 in CG (p = 0.01), respectively. No statistical significant difference was noted in DMFT indices between the 2 groups (8.04 ± 6.90 vs. 8.52 ± 6.24, p = 0.71). The following salivary parameters were significantly lower in TG compared to CG, respectively: mean SFR 0.44 ± 0.18 ml/min vs. 0.61 ± 0.26 ml/min; median levels of sodium and chlorides, 4 mmol/L and 13.5 mmol/L vs. 9 mmol/L and 19 mmol/L (p < 0.001) and uric acid, 103.50 mmol/L vs. 163 (p = 0.009). However, higher median levels were recorded with calcium, 1.09 mmol/L vs. 0.54 (p < 0.001) and sIgA 23 mg/dl vs. 5 mg/dl (p < 0.001). In TG, a positive correlation was found between DC, potassium, urea, and chlorides (p < 0.05). Salivary renal and hepatic biomarkers were comparable between the two groups.ConclusionsPLWHA have shown an alteration in some salivary parameters, more decayed teeth and less filled teeth. Preventive measures should be implemented to lower dental caries and enhance accessibility to oral care services. In addition, saliva can be utilized to monitor oral and general health status among PLWHA on ART.

Analysis of the Causes and Conditions for the Formation of a High Incidence of Acute Respiratory Infections (ARI) in the Population of the Altai Krai (Part 1. Features of Long-Term and Intra-Annual Dynamics of ARI Incidence in 2011–2021)

Relevance. The Altai Krai (AK) is among the least prosperous subjects of the Russian Federation in terms of the incidence of acute respiratory infections (ARI).Aim: to analyze the causes and conditions for the formation of a high incidence of ARI among the population of the Altai Krai based on an assessment of the long-term and intra-annual dynamics of the epidemic process in 2011–2021.Materials and methods. In the course of a retrospective epidemiological study according to the annual forms No. 2 of the state statistical observation (SOS) for 2011-2021 a comparative analysis of the incidence of ARI and community-acquired pneumonia (CAP) in various groups of the population of the AK, the Siberian federal district (SFD) and the population of the Russian Federation as a whole was carried out. Data for 2020–2021 («covid» period) was analyzed separately in comparison with the precovid period of 2011–2019. The intra-annual dynamics of the incidence of ARI and CAP in the AK were studied using the method of trend-seasonal decomposition according to the monthly forms No. 2 of the SOS.Results and discussion. It is established that in 2011–2021. the epidemic process of ARI in the AK was characterized by a higher level and rate of increase in the incidence of all population groups (adults and children, urban and rural) compared to the all-Russian and average for the Siberian Federal District; a higher proportion of children in the overall structure of ARI cases, despite the fact that the proportion of the child population did not exceed (or was even less) than in other regions; no decrease in the incidence of ARI in children in the period 2020–2021; the presence of a trend towards an increase in the incidence of ARI in both urban and rural residents in the pre-covid period; higher incidence in the rural population in 2011–2019 compared to the whole of the Russian Federation or the Siberian Federal District. A less pronounced role of the seasonal component in the registration of CAP was revealed, in comparison with ARI. In some years, an increase in the registration of CAP was observed in the spring-summer period. For 2020-2021 there was a close coincidence of the curves of the intra-annual dynamics of the registered incidence of ARI and COVID-19 among the general population, CAP and COVID-19.Conclusion. The obtained results indicate the need to study the possible impact of environmental factors, as well as the shortcomings of the etiological interpretation and differential diagnosis of some natural focal and zoonotic infections that occur with fever and respiratory symptoms on the formation of a high incidence of ARI in the Altai Territory.

Stable closure of acute and chronic wounds and pressure ulcers and control of draining fistulas from osteomyelitis in persons with spinal cord injuries: non-interventional study of MPPT passive immunotherapy delivered via telemedicine in community care.

Micropore particle technology (MPPT) is a topical wound treatment. It is a passive immunotherapy, acting via the skin and wound microbiome without the use of antimicrobial action. In a general patient population, it removed wound infections 60% and initiated tissue regeneration 50% quicker than antibiotics and antiseptics. As MPPT supports the immune system, the aim was to confirm that MPPT is also effective in immunocompromised individuals. People with spinal cord injury (SCI) are immunodeficient due to their injury and not an underlying disease and recruit 50% fewer immune cells to an injury. The study, therefore, determined the efficacy, safety, health economics, and sustainability of MPPT in acute and chronic wounds and pressure ulcers in this patient population. Pressure ulcers in SCI persons are an orphan indication, patient variability is high, and ICH E10 excludes comparators due to ethical concerns. The study design was, therefore, a single-arm, non-interventional, observational, post-market surveillance study of MPPT for treating wounds and pressure ulcers and removing soft tissue infection in connection with draining fistulas in SCI persons. The study was based on telemedicine in community care. The study included 44 wounds. All acute and chronic grade 1-4 wounds and pressure ulcers reached stable closure. In wounds acting as fistulas draining from an underlying, primary focus of infection, e.g., osteomyelitis, MPPT removed the soft tissue infection in approx. 2.5 months and supported regeneration, considerably reducing fistula sizes. Compared to standard care, per-wound cost savings were 51 to 94% depending on wound grade and age, and substantial nursing resources were freed up. The telemedicine approach was well received by participants and supported independence and self-care. The use of antimicrobials, plastics, and synthetic polymers was essentially eliminated. MPPT did not require bed rest. The study confirmed that MPPT is safe and effective in treating acute and chronic wounds in immunocompetent and immunocompromised individuals, including wounds with antimicrobial-resistant infections. MPPT also removes soft tissue infections caused by an underlying primary focus of infection, such as osteomyelitis. Non-healing wounds currently represent an unmet clinical need. The findings suggest that a therapy acting via the microbiome without antimicrobial actions is effective.

Comparison of procalcitonin levels with blood culture results and foci of infection in septic patients

Comparison of procalcitonin levels with blood culture results and foci of infection in septic patients

Comparison of procalcitonin levels with blood culture results and foci of infection in septic patients

Comparison of procalcitonin levels with blood culture results and foci of infection in septic patients

Presence of Enteric Fever with Unusual Clinical Scenarios: A Case Series

Salmonella species are associated with bacteraemia, diarrhoea, as well as focal infections. Salmonella Typhi is the most pathogenic species. Salmonella Paratyphi B commonly affects immunocompromised hosts. The present case series showcases six cases of infection caused by typhoidal Salmonellae with unusual clinical scenarios. The first case report explains a case of neonatal meningitis where the causative agent was S. Paratyphi B. A case of lumbar spondylodiscitis is also reported where the aetiology was found to be Salmonella Typhi. Case three reports S. Typhi infection in a patient with Pre-B cell Acute Lymphoblastic Leukemia (ALL). S. Paratyphi B was isolated from a blood culture of a patient on haemodialysis and also from ascitic fluid from a case of Chronic Liver Disease (CLD). S. Typhi was isolated from the pleural fluid of a patient with carcinoma of the prostate.

Atypical localization of metastatic melanoma in the gastrointestinal tract.

Although most melanomas are diagnosed in early stages of the disease, a significant percentage show metastases from the beginning or during follow-up. The most common route is lymphatic, while hematogenous spread is less frequent. The most common site for metastases is the skin itself, although they can also occur in other organs, including the digestive tract, where the small intestine is the most frequently affected organ (2). We present the case of a 48-year-old woman with a history of superficial spreading melanoma of the cervical region, surgically treated 7 years prior and in remission, who presented with painless jaundice of 48 hours duration, without fever or other infectious focus. Upon arrival at the Emergency Department, she had a direct bilirubin of 7.9 mg/dL and a CRP of 140 mg/L. An abdominal ultrasound was performed, revealing biliary tract dilation without apparent cause, with secondary, apparently tumoral involvement of the gallbladder. During hospitalization, the study was completed with an abdominal CT scan, visualizing hyperdense lesions with a polypoid appearance in the gallbladder, in addition to the aforementioned intra- and extrahepatic biliary tract dilation. The cause was then identified as a hyperdense mass in the duodenum affecting the papilla, along with two other small hypervascular polypoid lesions in the second portion of the duodenum. With these findings, an ERCP was performed, revealing a papilla with a "pregnant" appearance, compatible with ampulloma, in addition to duodenal pseudopolyps of nonspecific appearance. The anatomopathological analysis was compatible with duodenal metastases from melanoma. Melanoma is the cancer with the highest mortality rate, and the gastrointestinal tract is a typical location for metastases, only surpassed by the skin itself and the lungs, especially the small intestine, although not the duodenum, where they are found in only 12% of cases (4). In this case, the diagnosis was complicated by the endoscopic appearance of the lesion, as the characteristic features are pigmented, blackish lesions typical of melanoma. As seen in the image, these lesions had an erythematous and pseudo-inflammatory appearance, so for diagnosis and treatment, it was essential to consider the history of the disease to perform an adequate anatomopathological diagnosis.

Removal of Chlorhexidine for Ventilator-Associated Pneumonia Prevention with a Dentist Composing the Intensive Care Unit Team.

An association between the use of chlorhexidine in mechanically ventilated patients for the purpose of oral hygiene and the prevention of ventilator-associated pneumonia (VAP) lacks conclusive evidence in the literature. Therefore, this study aims to assess the clinical impact of such practice. This evaluation will consider that retention factors, infection foci, and oral biofilm will be regularly removed by a dentist. In this retrospective cohort study, a comparison was made between two groups, one using chlorhexidine and the other using saline solution. Patients from both groups included in this study were admitted between January 2016 to March 2018. Data such as the incidence of VAP, duration of mechanical ventilation (DMV), length of stay (LOS), and mortality rate (MR) were collected and compared between the groups. Only patients aged 18 or older, under mechanical ventilation for more than 48 consecutive hours were included. Were excluded from this study patients with a diagnosis of VAP or other pulmonary infection upon admission or within the first 48hours of hospitalization. Also not included were those who stayed in the ICU for less than 48hours. Dental treatment was carried out addressing the regular removal of retention factors, potential oral infection foci, and oral biofilm by a dentist. Additionally, at each appointment, the visible biofilm was removed by the dentist themselves, and the maintenance of oral hygiene was performed daily by the nursing staff. For the statistical analysis the non-parametric Mann-Whitney test was used for comparisons between groups regarding LOS and DMV. Additionally, the associations between groups and VAP, outcomes (discharge or death), and diseases were analyzed using the chi-square test and Fisher's exact test. A significance level of 5% was assumed. In both evaluated groups, each consisting of 36 patients, the incidence of VAP was identical at 2.8%. Specifically, the chlorhexidine group had an incidence of 2.105 VAP cases per 1000 days of mechanical ventilation (MV), while the placebo group had 2.865 VAP cases per 1000 days of MV (p = 1.000). No significant difference between groups regarding LOS (p = 0.5694) and DMV (p = 0.1136) was found. There was also no significant association between the MR in the two groups (47.2% chlorhexidine, 36.1% placebo) (p=0.3390). When intensive oral care is performed, the use of chlorhexidine shows no significant change in VAP incidence, MR, LOS, and DMV. Therefore, the dentist, as part of the multiprofessional team, should decide on its use.

The Use of Antibiotics at the End of Life: A Cross-Sectional Study.

To identify and analyze antibiotics' prescription patterns and associated factors among terminally ill patients at a hospital in southern Peru. A cross-sectional analytical study was conducted on adult patients who died in Hospital III Daniel Alcides Carrion in Tacna, Peru, 2023. Data were collected from electronic medical records, focusing on antibiotic use during the last hospitalization. Univariate, bivariate, and multivariate analyses were performed using Poisson regression to adjust for potential confounders. The study included 239 patients with an average age of 76. Antibiotics were administered to 93.72% of patients, with 42.46% lacking an identified infectious focus. Ceftriaxone, Meropenem, and Vancomycin were the most used antibiotics. A lower use of antibiotics within 72 hours prior to death was associated with hospitalizations longer than 18 days and having 2 or more comorbidities. The high prevalence of antibiotic use at the end of life, often without an infectious focus, suggests a need for better guidelines and education on palliative care to avoid inappropriate antibiotic prescribing. Improved communication between healthcare providers, patients, and families is essential for optimizing end-of-life care.

Рабдомиолиз — редкое внелегочное проявление внебольничной пневмонии, вызванной Mycoplasma pneumonia

Aim. To present a clinical case of a 19-year-old patient with community-acquired pneumonia (CAP) caused by Mycoplasma pneumoniae, which was complicated by a rare extrapulmonary manifestation in the form of rhabdomyolysis. Key points. The clinical case demonstrates a variant of mycoplasma CAP in an adult patient. M. pneumoniae infection was confirmed by a positive PCR test. Characteristic is contact with a patient with mycoplasma CAP in an infectious focus, a flu-like onset of the disease. Unlike most mild mycoplasma infections with a minimally expressed clinical picture and inflammatory response, the patient had a long period of febrile temperature and severe intoxication, significant laboratory changes and bilateral polysegmental lung damage. The development of signs of rhabdomyolysis (myalgia, increased creatine phosphokinase (CPK) to 2066 U/L, myoglobinuria) in the acute period of the disease is a rare extrapulmonary manifestation of mycoplasma CAP in adults, dangerous for the development of acute renal failure (ARF). Conclusion. The patient's young age, timely initiation of hydration, and antibacterial therapy aimed at M. pneumoniae made it possible to prevent the development of acute renal failure due to rhabdomyolysis. An increase in CPK, in the absence of other explanations for this phenomenon, should include mycoplasma CAP in the differential diagnosis of rhabdomyolysis. Keywords: community-acquired pneumonia, Mycoplasma pneumoniae, creatine phosphokinase, rhabdomyolysis.

Влияние антропогенных факторов на активность клещей семейства Ixodidae: история исследований в России

While studying the characteristics of the formation and existence of foci of transmissible tick-borne infections, it is essential to consider both natural and anthropogenic factors. The impact of human activity on this process undoubtedly requires constant attention. Retrospective studies conducted in our country and the post-Soviet space within this framework are systematized in this review according to the following periodization: the observation and knowledge accumulation stage; the fundamental research enhancement stage; and the contemporary stage. The review provides a characterization and trend analysis of studies on the anthropogenic impact on populations of ticks from the Ixodidae family, highlighting the most significant scientific works and results obtained on the subject. The concluding section emphasizes the importance of accumulating and structuring research to ensure the epidemiological well-being of the population.

ЗАБОЛЕВАЕМОСТЬ ИКСОДОВЫМ КЛЕЩЕВЫМ БОРРЕЛИОЗОМ У ЖИТЕЛЕЙ КРАСНОЯРСКОГО КРАЯ, ПЕРЕНЕСШИХ COVID-19

A retrospective epidemiological analysis of the incidence of natural focal zoonotic infections among the human population in the Krasnoyarsk Kray showed that the increase in the incidence of ixodid tick-borne borreliosis in 2022 could be caused by an increase in the number of people with post-acute COVID-19 syndrome, who probably have dysregulation of the immune response and increased sensitivity to various pathogens. There were no significant gender differences in infectious sensitivity to Borrelia in people who underwent COVID-19. At the same time, among people diagnosed with borreliosis, the proportion of women who have previously had COVID-19 is increased. The same happens with tick-borne encephalitis: a higher infectious sensitivity of women to the encephalitis virus is a statistically justified fact in people who have undergone COVID-19. Key words: COVID-19, ixodid tick-borne borreliosis, Krasnoyarsk Kray